<div class="modal fade modal-cuckoo" id="feedback_form">
  <form class="modal-dialog">
    <div class="modal-content">
      <div class="modal-header">
        <h4><i class="fa fa-bug"></i> Feedback</h4>
      </div>
      <p class="modal-section arrow">Expecting different results? Share this analysis report with us and we’ll investigate it. Please include a brief message of what you had expected to see and what you got instead.</p>

      <div class="modal-section modal-form arrow">
        <div class="form-col">
          <fieldset>
            <input type="text" name="name" id="feedback-name" required />
            <label for="feedback-name">Your name</label>
          </fieldset>
          <fieldset>
            <input type="text" name="email" id="feedback-email" required />
            <label for="feedback-email">Your email</label>
          </fieldset>
        </div>
        <div class="form-col">
          <fieldset>
            <input type="text" name="company" id="feedback-company" required />
            <label for="feedback-company">Your company</label>
          </fieldset>
        </div>
      </div>

      <div class="modal-section modal-form arrow">
        <textarea name="message" id="feedback-message" placeholder="Describe to us what does not seem to work properly."></textarea>
      </div>

      <div class="modal-section modal-form arrow arrow-center" id="feedback-includes">
        <div class="modal-form__checkbox">
          <input type="checkbox" name="include_analysis" id="feedback-analysis" />
          <label for="feedback-analysis"><span></span> Include analysis</label>
        </div>
        <div class="modal-form__checkbox">
          <input type="checkbox" name="include_memdump" id="feedback-memdump" />
          <label for="feedback-memdump"><span></span> Include memory dump</label>
        </div>
      </div>

      <div class="modal-section modal-form no-flex center">
        <p id="feedback-size">Estimated report size: <strong class="file-estimation">estimating...</strong></p>
        <button class="modal-submit" type="submit" formnovalidate>Send feedback report</button>
        <p>or <a href="modal:cancel">cancel</a></p>
      </div>

      <div class="modal-section modal-footer center"></div>
    </div>
  </form>
</div>
